SSHB 118: "An Act expanding, and relating to advertising about, medical assistance coverage for eligible children and pregnant women; relating to the poverty guideline and cost sharing for certain recipients of medical assistance; having the short title of the 'No Child Left Uninsured Act'; and providing for an effective date."
00 SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 118 01 "An Act expanding, and relating to advertising about, medical assistance coverage for 02 eligible children and pregnant women; relating to the poverty guideline and cost sharing 03 for certain recipients of medical assistance; having the short title of the 'No Child Left 04 Uninsured Act'; and providing for an effective date." 05 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 06 * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 07 to read: 08 SHORT TITLE. This Act may be known as the No Child Left Uninsured Act. 09 * Sec. 2. AS 47.07.020(b) is amended to read: 10 (b) In addition to the persons specified in (a) of this section, the following 11 optional groups of persons for whom the state may claim federal financial 12 participation are eligible for medical assistance: 13 (1) persons eligible for but not receiving assistance under any plan of 14 the state approved under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act,
01 Supplemental Security Income) or a federal program designated as the successor to the 02 aid to families with dependent children program; 03 (2) persons in a general hospital, skilled nursing facility, or 04 intermediate care facility, who, if they left the facility, would be eligible for assistance 05 under one of the federal programs specified in (1) of this subsection; 06 (3) persons under 21 years of age who are under supervision of the 07 department, for whom maintenance is being paid in whole or in part from public 08 funds, and who are in foster homes or private child-care institutions; 09 (4) aged, blind, or disabled persons, who, because they do not meet 10 income and resources requirements, do not receive supplemental security income 11 under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act), and who do not 12 receive a mandatory state supplement, but who are eligible, or would be eligible if 13 they were not in a skilled nursing facility or intermediate care facility to receive an 14 optional state supplementary payment; 15 (5) persons under 21 years of age who are in an institution designated 16 as an intermediate care facility for the mentally retarded and who are financially 17 eligible as determined by the standards of the federal program designated as the 18 successor to the aid to families with dependent children program; 19 (6) persons in a medical or intermediate care facility whose income 20 while in the facility does not exceed $1,656 a month but who would not be eligible for 21 an optional state supplementary payment if they left the hospital or other facility; 22 (7) persons under 21 years of age who are receiving active treatment in 23 a psychiatric hospital and who are financially eligible as determined by the standards 24 of the federal program designated as the successor to the aid to families with 25 dependent children program; 26 (8) persons under 21 years of age and not covered under (a) of this 27 section, who would be eligible for benefits under the federal program designated as 28 the successor to the aid to families with dependent children program, except that they 29 have the care and support of both their natural and adoptive parents; 30 (9) pregnant women not covered under (a) of this section and who 31 meet the income and resource requirements of the federal program designated as the
01 successor to the aid to families with dependent children program; 02 (10) persons under 21 years of age not covered under (a) of this section 03 who the department has determined cannot be placed for adoption without medical 04 assistance because of a special need for medical or rehabilitative care and who the 05 department has determined are hard-to-place children eligible for subsidy under 06 AS 25.23.190 - 25.23.210; 07 (11) persons who can be considered under 42 U.S.C. 1396a(e)(3) (Title 08 XIX, Social Security Act, Medical Assistance) to be individuals with respect to whom 09 a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c (Title 10 XVI, Social Security Act) because they meet all of the following criteria: 11 (A) they are 18 years of age or younger and qualify as disabled 12 individuals under 42 U.S.C. 1382c(a) (Title XVI, Social Security Act); 13 (B) the department has determined that 14 (i) they require a level of care provided in a hospital, 15 nursing facility, or intermediate care facility for the mentally retarded; 16 (ii) it is appropriate to provide their care outside of an 17 institution; and 18 (iii) the estimated amount that would be spent for 19 medical assistance for their individual care outside an institution is not 20 greater than the estimated amount that would otherwise be expended 21 individually for medical assistance within an appropriate institution; 22 (C) if they were in a medical institution, they would be eligible 23 for medical assistance under other provisions of this chapter; and 24 (D) home and community-based services under a waiver 25 approved by the federal government are either not available to them under this 26 chapter or would be inappropriate for them; 27 (12) disabled persons, as described in 42 U.S.C. 28 1396a(a)(10)(A)(ii)(XIII), who are in families whose income, as determined under 29 applicable federal regulations or guidelines, is less than 250 percent of the federal 30 poverty guideline for Alaska as defined by the United States Department of 31 Health and Human Services and revised under 42 U.S.C. 9902(2) [OFFICIAL
01 POVERTY LINE] applicable to a family of that size [ACCORDING TO THE 02 UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES], and 03 who, but for earnings in excess of the limit established under 42 U.S.C. 04 1396d(q)(2)(B), would be considered to be individuals with respect to whom a 05 supplemental security income is being paid under 42 U.S.C. 1381 - 1383c; a person 06 eligible for assistance under this paragraph who is not eligible under another provision 07 of this section shall pay a premium or other cost-sharing charges according to a sliding 08 fee scale that is based on income as established by the department in regulations; 09 (13) persons under 19 years of age who are not covered under (a) of 10 this section and whose household income does not exceed 200  percent of the 11 federal poverty guideline for Alaska [LINE] as defined by the United States 12 Department of Health and Human Services and revised under 42 U.S.C. 9902(2); 13 (14) pregnant women who are not covered under (a) of this section and 14 whose household income does not exceed 250  percent of the federal poverty 15 guideline for Alaska [LINE] as defined by the United States Department of Health 16 and Human Services and revised under 42 U.S.C. 9902(2); 17 (15) persons who have been diagnosed with breast or cervical cancer 18 and who are eligible for coverage under 42 U.S.C. 1396a(a)(10)(A)(ii)(XVIII). 19 * Sec. 3. AS 47.07 is amended by adding new sections to read: 20 Sec. 47.07.022. Extended medical assistance coverage for children; costs. 21 (a) In addition to the persons specified in AS 47.07.020, a person who resides in the 22 state and who meets the criteria under (b) of this section is eligible for extended 23 medical assistance coverage equivalent to the mandatory and optional services 24 described under AS 47.07.030 if the person submits an annual application and pays the 25 premium required under (c) of this section and any copayment required under (d) of 26 this section for the previous year. 27 (b) The department shall administer a program of extended medical assistance 28 coverage for a person 29 (1) who is under 19 years of age; 30 (2) whose household income is over 200 percent of the federal poverty 31 guideline for Alaska set by the United States Department of Health and Human
01 Services and revised under 42 U.S.C. 9902(2); and 02 (3) whose parent or legal guardian certifies that the person cannot 03 obtain adequate coverage for a reasonable cost under a health insurance policy offered 04 by an employer of the person's parent or legal guardian; if a policy is not offered by an 05 employer, the employer must be in compliance with federal law. 06 (c) The program administered under this section must include an annual 07 application fee and sliding scale premium, payable under terms specified in 08 regulations adopted by the department. The regulations must 09 (1) include the option of an assignment of a permanent fund dividend 10 of the applicant and the permanent fund dividend of a parent, legal guardian, or other 11 authorized representative of an applicant; 12 (2) set an annual premium amount of not less than two percent and not 13 more than five percent of the person's household income; and 14 (3) except as provided in (2) of this subsection, for a person whose 15 household income exceeds 300 percent of the federal poverty guideline for Alaska, set 16 a premium that is equal to the cost to the state of the average annual medical services 17 and prescription drug costs for a person under 19 years of age paid by the department 18 under the program. 19 (d) In addition to the annual premium established under (c) of this section, to 20 the extent permitted by federal law, for a person whose household income exceeds 250 21 percent of the federal poverty guideline for Alaska, the department shall impose a 22 copayment, to be paid at the end of the year, that is $500 plus 20 percent of the annual 23 medical services and prescription drug costs for a person under 19 years of age paid by 24 the department under the program. 25 (e) A combined annual premium paid under (c) of this section and annual 26 copayment paid under (d) of this section may not exceed five percent of the person's 27 household income. 28 (f) A copayment set under (d) of this section may not include the department's 29 costs that are associated with a physical exam and tests associated with a physical 30 exam. 31 Sec. 47.07.023. Advertising of medical assistance coverage. The department
01 shall, to the extent funding is available in one calendar month each year, spend 02 $25,000 that month advertising on television and radio the medical assistance program 03 benefits available to persons under 21 years of age and to pregnant women. 04 * Sec. 4. AS 47.07.042(d) is amended to read: 05 (d) In addition to the requirements established under (a) and (b) of this section, 06 the department shall [MAY] require premiums and [OR] cost-sharing contributions 07 from recipients as set out in AS 47.07.022. The [WHO ARE ELIGIBLE FOR 08 BENEFITS UNDER AS 47.07.020(b)(13) AND WHOSE HOUSEHOLD INCOME 09 IS BETWEEN 150 AND 175 PERCENT OF THE FEDERAL POVERTY LINE. IF 10 THE DEPARTMENT REQUIRES PREMIUMS OR COST-SHARING 11 CONTRIBUTIONS UNDER THIS SUBSECTION, THE] department 12 (1) [SHALL ADOPT IN REGULATION A SLIDING SCALE FOR 13 THOSE PREMIUMS OR CONTRIBUTIONS BASED ON HOUSEHOLD INCOME; 14 (2)] may not exceed the maximums allowed under federal law; and 15 (2) [(3)] shall implement a system by which the department or its 16 designee collects those premiums or contributions. 17 * Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to 18 read: 19 TRANSITION: REGULATIONS. The Department of Health and Social Services may 20 proceed to adopt regulations necessary to implement the changes made by this Act. The 21 regulations take effect under AS 44.62 (Administrative Procedure Act), but not before the 22 effective date of secs. 2 - 4 of this Act. 23 * Sec. 6. The uncodified law of the State of Alaska is amended by adding a new section to 24 read: 25 CONTINGENT EFFECT. AS 47.07.022, added by sec. 3 of this Act, takes effect only 26 if, before July 1, 2011, the United States Department of Health and Human Services has 27 approved the changes made in that section. 28 * Sec. 7. If AS 47.07.022, added by sec. 3 of this Act, takes effect, it takes effect on the date 29 that the revisor of statutes receives notice from the commissioner of health and social services 30 that the United States Department of Health and Human Services has approved the changes 31 made in that section.
01 * Sec. 8. Sections 5 and 6 of this Act take effect immediately under AS 01.10.070(c). 02 * Sec. 9. Except as provided in secs. 7 and 8 of this Act, this Act takes effect July 1, 2009.